Lawsuit defending doctors' right to ask patients about firearms

8/6/2019 Lawsuit defending doctors' right to ask patients about firearms

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ASTIGARRAGA DAVIS MULLINS &GROSSMAN,P.A.

IN THE UNITED STATES DISTRICT COURTFOR THE SOUTHERN DISTRICT OF FLORIDA

MIAMI DIVISIONCIVIL ACTION NO. ________________

DR. BERND WOLLSCHLAEGER

DR. JUDITH SCHAECHTER

DR. TOMMY SCHECHTMAN

AMERICAN ACADEMY OF

PEDIATRICS, FLORIDA CHAPTER

AMERICAN ACADEMY OF FAMILY

PHYSICIANS, FLORIDA CHAPTER

AMERICAN COLLEGE OF

PHYSICIANS, FLORIDA CHAPTER, INC.

Plaintiffs,

v.

RICK SCOTT

In his official capacity as Governor of the State

of Florida

KURT S. BROWNING

In his official capacity as Secretary of State of

the State of Florida

FRANK FARMERIn his official capacity as Surgeon General of

the State of Florida

ELIZABETH DUDEK

In her official capacity as Secretary of Health

Care Administration of the State of Florida

LUCY GEEIn her official capacity asDivision Director ofthe Florida Department of Health, Division of

Medical Quality Assurance

Defendants.

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COMPLAINT FOR DECLARATORY

AND INJUNCTIVE RELIEF

Case 1:11-cv-22026-MGC Document 1 Entered on FLSD Docket 06/06/2011 Page 1 of 26


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3ASTIGARRAGA DAVIS MULLINS &GROSSMAN,P.A.

3. Specifically, the Physician Gag Law expressly restricts health care practitioners,in certain vaguely-defined circumstances, from asking patients questions related to gun safety or

recording information from those conversations in patients medical records, on penalty of harsh

disciplinary sanctions, including fines and permanent revocation of their licenses to practice

medicine. Moreover, the statute prohibits unnecessar[y] harass[ment] and discrimination on

the basis of a patients possession or ownership of a firearm, but defines neither of those terms,

leaving their definitions to the eye of the beholder. As a result, some health care practitioners

who are simply following established protocol by informing patients how they may limit the

lethal risks posed by firearms may be hauled before a disciplinary board because a patient who

categorically objects to any discussion or inquiry regarding such risks claims to be offended.

4. Thus, in addition to establishing express prohibitions on protected speech, thePhysician Gag Law is also so vague, and its sanctions so severe, that it chills health care

practitioners discussions of gun safety with their patients even in situations arguably permitted

by the law. Fearing the prospect of professionally devastating public disciplinary proceedings,

practitioners are left to assume the laws vague speech prohibitions will be construed to prohibit,

and therefore will self-censor, their speech regarding how patients can best minimize the risks of

injury and death associated with gun ownership.

5. The Physician Gag Law consequently not only will deprive physicians and otherhealth care practitioners of their First Amendment right to freedom of speech, but also will

deprive patients of their First Amendment rights to receive potentially life-saving information

regarding safety measures they can take to protect their children, families, and others from injury

or death resulting from unsafe storage or handling of firearms.



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6. By restricting the free and open exchange of information between a physician andpatient in this manner, the Physician Gag Law violates the First and Fourteenth Amendments to

the U.S. Constitution. Accordingly, Dr. Bernd Wollschlaeger, Dr. Judith Schaechter, Dr.

Tommy Schechtman, the Florida Chapter of the American Academy of Pediatrics (FAAP), the

Florida Chapter of the American Academy of Family Physicians (FAFP), and the Florida

Chapter of the American College of Physicians (FACP) (collectively, Plaintiffs) on their

own behalf, on behalf of their more than 11,000 collective members (collectively, health care

practitioners or practitioners), and on behalf of their patients, herewith seek declaratory and

injunctive relief prohibiting enforcement of the provisions of Florida Statutes sections 381.026,

395.1055, 790.338 and 456.072 amended or created by CS/CS/HB 155, entitled An act relating

to the privacy of firearm owners (the Physician Gag Law). Plaintiffs have sustained

immediate and irreparable harm to their free speech rights from these provisions and, therefore,

seek a declaration that the Physician Gag Law is unconstitutional and an injunction against its

enforcement.

JURISDICTION AND VENUE

7. This action is brought pursuant to 42 U.S.C. 1983 to redress the deprivation,under color of state law, of rights secured by the Constitution of the United States.

8. This Court has jurisdiction over this action under 28 U.S.C. 1331 (federalquestion), and it may issue a declaratory judgment and grant further relief pursuant to 28 U.S.C.

2201 and 2202.

9. Venue appropriately lies in this District pursuant to 28 U.S.C. 1391.



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10. Because the Physician Gag Law constitutes an immediate infringement on thefree speech rights of Plaintiffs, their members, and their patients, an actual and justiciable

controversy exists between Plaintiffs and Defendants.

11. Plaintiffs have standing to bring this action.PARTIES

12. Plaintiff Dr. Bernd Wollschlaeger is a physician specializing in family medicineand addiction medicine. He is licensed to practice medicine in Florida and is Board-certified in

Family Medicine and Addiction Medicine. He resides in Miramar, Florida, and practices

medicine from an office located in North Miami Beach, Florida. He is a member of FAFP and

currently serves on its Board of Directors.

13. Plaintiff Dr. Judith Schaechter is a physician specializing in pediatric medicine.She is licensed to practice medicine in Florida and is Board-certified in Pediatric Medicine. She

resides in Miami Beach, Florida, and practices medicine in the City of Miami, Florida. She is a

member of FAAP and is Chair of FAAPs Child Safety Committee.

14. Plaintiff Dr. Tommy Schechtman is a physician specializing in pediatricmedicine. He is licensed to practice medicine in Florida and is Board-certified in Pediatric

Medicine. He resides and practices medicine in Palm Beach Gardens, Florida. He is a member

of FAAP, serves on its Board of Directors, and is Secretary of FAAP.

15. Plaintiff American Academy of Pediatrics, Florida Chapter (FAAP), alsoknown as the Florida Pediatric Society, is a non-profit professional organization of pediatricians

and pediatric specialists, incorporated under the laws of Florida, with over 1,600 members

throughout the State of Florida, including Miami-Dade County. The mission of FAAP and its

members is to improve access to, and the quality of, heath care for infants, children, and young



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adults in Florida. FAAP promotes the health and welfare of, and advocates for, Floridas infants,

children and young adults.

16. Plaintiff American Academy of Family Physicians, Florida Chapter (FAFP),also known as the Florida Academy of Family Physicians, Inc., is composed of more than 4,000

family medicine physicians, residents, and medical students throughout the State of Florida,

including Miami-Dade County. Incorporated under the laws of Florida, FAFP works to advance

the specialty of family medicine by promoting excellence and improvement in the health care of

all Floridians, including helping all Floridians understand that having a family physician is vital

to their health. FAFP also acts as a voice for family medicine, engaging in advocacy on key

issues among patients and the medical community.

17. Plaintiff American College of Physicians, Florida Chapter, Inc. (FACP) is theFlorida chapter of the American College of Physicians (ACP), a national organization of

internists, who are physicians specializing in the prevention, detection, and treatment of illnesses

in adults. Incorporated in Florida, FACP has approximately 5,800 members cross the State of

Florida, including Miami-Dade County. The mission of FACP is to enhance the quality and

effectiveness of health care by fostering excellence and professionalism in the practice of

medicine. FACPs goals in furtherance of this mission include establishing and promoting the

highest clinical standards and ethical ideals; serving as the foremost comprehensive education

and information resource for all internists; advocating responsible positions on behalf of its

members; and promoting research to enhance the quality of practice, the education, and

continuing education of internists. FACP also cooperates with ACP in publishing, promoting,

and disseminating practice guidelines, policy statements, and academic and professional

literature relating to best practices in internal medicine.



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18. Defendant Rick Scott is sued in his official capacity as the Governor of the Stateof Florida. Mr. Scott signed the Physician Gag Law on June 2, 2011. Under Florida law, Mr.

Scott has the power to appoint the Surgeon General and the Secretary of Health Care

Administration, both of whom serve at the pleasure of the Governor. See Fla. Stat. 20.43(2)(a),

20.42(2). Mr. Scott also appoints the members of each board within the Florida Department of

Healths Division of Medical Quality Assurance, including the Board of Medicine. See id.

20.43(4)(a).

19. Defendant Kurt S. Browning is sued in his official capacity as Secretary of Stateof Florida. Under Florida law, Mr. Brownings responsibilities include maintaining custody of

the original statutes of Florida, resolutions of the Florida legislature, and all official

correspondence of the Governor of Florida. Mr. Browning also maintains an index of all orders

and official acts issued or received by the Governor or himself. See Fla. Stat. 15.01.

20. Defendant Frank Farmer is sued in his official capacity as the State SurgeonGeneral of Florida. Under Florida law, Mr. Farmers responsibilities include leading the Florida

Department of Health (Department) and regulating physicians and other health professionals

as authorized by law. See Fla. Stat. 20.43, 381.026, 456.072, 790.338. The Department has

investigative and disciplinary powers and may impose penalties for violations of the Physician

Gag Law under Florida law. Id.

21. Defendant Elizabeth Dudek is sued in her official capacity as Secretary of HealthCare Administration of the State of Florida. Under Florida law, Ms. Dudek is the head of the

Agency for Health Care Administration (Agency), and her responsibilities include health

facility licensure, inspection, and regulatory enforcement and investigation of consumer

complaints related to health care facilities. See Fla. Stat. 20.42, 381.026, 395.1055, 790.338.



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The Agency has regulatory and enforcement powers and may impose penalties for violations of

the Physician Gag Law under Florida law.

22. Defendant Lucy Gee is sued in her official capacity as Division Director of theFlorida Department of Health, Division of Medical Quality Assurance (Division). Under

Florida law, Ms. Gees responsibilities include the administration of various boards and

professions, including the Board of Medicine, and their associated investigation, enforcement,

and disciplinary powers concerning physicians and other health professionals. See Fla. Stat.

20.43, 456.072, 790.338. The Division has investigative and disciplinary powers and may

impose penalties for violations of the Physician Gag Law under Florida law. Id.

FACTUAL BACKGROUND

A. Necessity of Safety Counseling as Preventative Medicine

23. Intentional injury, resulting from behaviors designed to hurt oneself or others, is amajor health hazard for children and adults of all ages. Suicide is a particularly significant risk

about which physicians and other health care practitioners must routinely counsel patients. In

the United States, suicide is the third-leading cause of death for individuals below the age of 21

and the second-leading cause of death for adults aged 25 to 34. The highest rate of suicide for

women occurs in their 40s and 50s; and, for men, the highest rate is among those age 75 or older.

Firearms frequently are used in such suicides and suicide attempts.

24. Unintentional injury is also a health hazard for patients of all ages, and, indeed, isthe leading cause of death and morbidity among children older than one year, adolescents, and

young adults. Such injuries arise from many causes, including falls, burns, poisoning, choking,

drowning, recreational activities, sportsand accidents involving firearms.



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25. In light of these risks, prevention of unintentional and intentional injury is a life-long aspect of preventative care, stretching from before birth all the way to old age. Preventative

care is a pillar of the practice of medicine. In a modern rendition of the Hippocratic Oath,

administered across the country, a physician swears to prevent disease whenever I can, for

prevention is preferable to cure. Dr. Louis Lasagna, Would Hippocrates Rewrite His Oath?,

New York Times Magazine (June 28, 1964). Along with preventing the onset of disease, a

crucial element of practicing medicine is the prevention of intentional and unintentional physical

injuries. Health care practitioners play a key role in counseling patients, their parents, and other

caregivers about the risks of injuries and best practices to minimize those risks.

26. To those ends, the American Academy of Pediatrics (AAP) and FAAPrecommend preparing a child-safe home before a child is born, and that pediatricians

anticipatory guidance on household safety issues begin after an infant is 2 days old. Such

anticipatory guidance on minimizing these risks is a major component of well-child care and

preventative medicine, and is recommended by AAP as an integral part of the medical care

provided for all infants, children, and adolescents. Indeed, AAP has established a nation-wide

initiative, The Injury Prevention Program (TIPP), with the aim of helping health care

professionals counsel parents and children about adopting behaviors that can prevent injuries and

has published age-specific clinical guidance on injury prevention for pediatricians. Both AAP

and FAAP encourage health care practitioners to document injury-prevention counseling in a

patients medical chart. Injury prevention continues into adulthood and beyond for the elderly.

27. As Plaintiffs and health care practitioners everywhere are well aware, firearmscontribute to both intentional and unintentional injuries and deaths for patients of every age.

Every year, thousands of Americans are seriously injured or killed when a child finds a gun and



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accidentally pulls the trigger, an argument between acquaintances or family members spins out

of control, or a depressed teenager or adult becomes suicidal. Suicide attempts committed with

guns are fatal more than 90% of the time. Use of a firearm is the most common method of

suicide among men56.8%, as of 2007.

28. Firearms pose particular risks in households with children. Every day in America65 children and teens are shot with firearms, and eight of them die. One third of U.S. homes

with children younger than eighteen have a firearm. More than 40 percent of gun-owning

households with children store their guns unlocked and one quarter of those homes store them

loaded.

29. Each year, Florida children are harmed when they or other children gain access tofirearms that have not been stored properly. Floridas overall gun death rate is higher than the

national average. From 1999 to 2007, 1,195 children and teens in Florida were shot and killed

with firearms. In a mere two-month span last year, from February 8, 2010 through March 26,

2010, four Florida children died from injuries accidentally inflicted by firearms. In one incident,

an 11-year-old boy died after accidentally being shot in the face by his little brother; the boys

had been sent to the parking lot outside their home to retrieve a hat from their fathers truck, and,

while searching for it, the 10-year-old found a gun and shot and killed his brother. Janie

Campbell, Boy Accidentally Kills Brother With Dads Gun, NBC Miami, February 28, 2010.

In another, a 2-year-old girl accidentally shot herself with a .380 caliber semi-automatic handgun

she found on the nightstand next to her mothers bed. Steve Nichols, Arrest in toddlers

accidental shooting, Fox 13 Pinellas, March 27, 2010. A 15-year-old boy was shot once in the

head by another minor inside a home. Anika Myers Palm, 15-year-old boy accidentally shot in

head in gun-playing incident, Orlando Sentinel, February 8, 2010. And a 17-year-old



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accidentally shot his friend at home while twirling a handgun on his finger. Associated Press,

Florida Teen Accidentally Shoots Friend While Twirling Gun, Fox News, March 6, 2010.

30. Anticipatory safety guidance regarding firearms is thus a crucial part of thepractice of preventative medicine in Florida.

31. AAP and FAAP recommend that health care practitioners tailor theirrecommendations to patients circumstances. See H. Garry Gardner and the Committee on

Injury, Violence, and Poison Prevention, Office-Based Counseling for Unintentional Injury

Prevention, 119 Pediatrics 202 (Jan. 2007) (describing measures appropriate to infants,

preschool-aged children, school-aged children, and adolescents, with regard to risks posed by

sleep environments, choking, traffic, poisons, falls, burns, water and drowning, sports, and

firearms). For parents of preschool-aged children, because of the dangers that in-home firearms,

particularly handguns, pose to young children, AAP and FAAP recommend that parents should

be advised to keep handguns out of places where children live and play. If parents choose to

keep a firearm in the home, the unloaded gun and ammunition must be kept in separate locked

cabinets.

32. For parents of school-aged children, AAP and FAAP recommend advising parentsthat, in addition to removing firearms from the home environment where children explore and

play, parents should also ask whether there is a gun in any home that their children visit. If

parents choose to keep a firearm in the home, the unloaded gun and ammunition must be kept in

separate locked cabinets.

33. With respect to adolescents, AAP and FAAP recommend that health carepractitioners inform parents that in-home firearms are particularly dangerous during adolescence

because of the potential for impulsive, unplanned use by teens resulting in suicide, homicide, or



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serious unintentional injuries. They recommend that firearms, and especially handguns, should

be kept out of the home for parents of adolescents at risk of suicide. If parents choose to keep a

firearm in the home, the unloaded gun and ammunition must be kept in separate locked cabinets.

Parents should ask whether there is a gun in any home that teenagers visit.

34. Consultations regarding firearm safety are also a routine part of adult medicalcare, help adult patients minimize heath hazards, and are particularly important in the context of

treating mental health conditions. The American Psychiatric Association has recommended that

health professionals and health systems should ask about firearm ownership whenever clinically

appropriate in the judgment of the physician.

35. These recommendations are derived from medical and scientific studies, andPlaintiffs and their members view them as a key part of minimizing risks that firearms pose to

the health of children, adolescents, adults, and their family members. Plaintiffs counsel their

patients regarding these preventative measures as part of the recommended anticipatory safety

guidance and medical care. Such consultations frequently involve engaging patients in a

dialogue about the preventative measures, both in order to inculcate and reinforce physicians

medical advice and in order to tailor this advice to the patients particular circumstances. In

addition, in an attempt to further reinforce such guidance, AAP has produced literature available

for distribution by Florida health care practitioners, including fact-sheets patients can take home

with them describing how to mitigate the risks posed by firearms.

36. This aspect of preventative carecounseling patients on firearm safetyalsodirectly assists Florida parents in complying with Floridas firearms laws, including a law passed

by the Florida Legislature specifically to protect children. Florida law requires that a person who

has stored a firearm, and who knows or reasonably should know that a minor is likely to gain



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access to the firearm shall keep the firearm in a securely locked box or container or in a

location which a reasonable person would believe to be secure or shall secure it with a trigger

lock. Fla. Stat. 790.174(1). Failure to secure a firearm in this fashion is a misdemeanor. Id.

790.174(2). The Florida Legislature passed this law upon find[ing] that a tragically large

number of Florida children have been accidentally killed or seriously injured by negligently

stored firearms; that placing firearms within the reach or easy access of children is irresponsible,

encourages such accidents, and should be prohibited; and that legislative action is necessary to

protect the safety of our children. Id. 790.173(1).

B. The Physician Gag Law

37. Each of the Physician Gag Laws four main provisions imposes a restriction onhealth care practitioners speech on the particular subject matter of firearms. The law, entitled

An act relating to the privacy of firearm owners, purports to protect the privacyof Florida

firearm owners. It does not, in fact, advance firearms owners rights under the Second

Amendment to the U.S. Constitution. Owners of firearms in Florida remain subject to, for

instance, the Florida statute requiring safe storage of firearms in homes with children, described

above. See Fla. Stat. 790.174. Rather than furthering a right to beararms, the Physician Gag

Law restricts discussion of firearms.

38. First, the Physician Gag Law restricts health care practitioners and facilities frommaking a written inquiry or asking questions concerning particular subjects: the ownership of

a firearm or ammunition by the patient or by a family of a member of the patient, and the

presence of a firearm in a private home or other domicile of the patient or a family member of

the patient. Fla. St. 790.338(2), 381.026(4)(b)(8). The law carves out an exception if the



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practitioner or facility in good faith believes that this information is relevant to the patients

medical care or safety, or the safety of others. Id. 790.338(2), 381.026(4)(b)(8).

39. Second, the Physician Gag Law restricts practitioners from writing information onthe subject of firearm ownership in patients medical records, thus restricting written

communication among practitioners within a health care facility on the subject of preventative

care related to firearm ownership. The statute prohibits health care practitioners and facilities

from intentionally enter[ing] any disclosed information concerning firearm ownership into the

patients medical record if the practitioner knows that such information is not relevant to the

patients medical care or safety, or the safety of others. Fla. Stat. 790.338(1).

40. With respect to these first two provisions, the Physician Gag Law does not specifywhat constitutes relevan[ce] to the patients medical care or safety, or the safety of others for

purposes of the statute. As a consequence, practitioners are left uncertain as to those situations in

which they are prohibited from making inquiries of their patients regarding the presence or

ownership of a firearm, or entering such information into patients records.

41. Another provision of the Physician Gag Law, governing emergency medicaltechnicians (EMTs), sets a high standard for relevance. The statute authorizes EMTs to

inquire about a patients possession of a firearm or the presence of a firearm in the home, but

only if the EMT in good faith believes that [such] information is necessary to treat a patient

during the course and scope of a medical emergency or that the presence or possession of a

firearm would pose an imminent danger or threat to the patient or others. Fla. Stat.

790.338(3).

42. The statute nowhere specifies whether the standard for relevance that wouldpermit a health care practitioner to make inquiry about or record information regarding the



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presence or ownership of guns in the home is similarly limited to circumstances where such

information relates to a medical emergency or imminent danger or threat.

43. The Physician Gag Laws third main restriction on health care practitionersspeech is its prohibition of unnecessarily harassing patients on the subject of firearm

ownership. See Fla. Stat. 790.338(6), 381.026(4)(b)(11). Although the provision does not

define harassment, under any natural reading of the statute (however narrow or broad), such

harass[ment] would largely or entirely consist of a practitioners speech regarding firearms

directed to a patient.

44.

Although some patients might perceive as harassment an inquiry that another

patient welcomes, the Physician Gag Law provides no guidance regarding what kind of conduct

would subject a practitioner or facility to disciplinary proceedings for having engaged in

harassment. Any individual patient who feels harassed by a practitioners questions related to

gun safety can report a practitioner for violating the Physician Gag Law.

45. Fourth, the Physician Gag Law prohibits discriminat[ion] based solely uponthe patients exercise of the constitutional right to own and possess firearms or ammunition.

See Fla. Stat. 790.338(5), 381.026(4)(b)(10). Because the meaning of this prohibition is

wholly unclear, it imposes a further burden on, and further serves to restrict, practitioners

speech directed to patients regarding the subject matter of firearms.

46. The Physician Gag Law subjects health care practitioners and facilities accused ofviolating the statute to disciplinary proceedings and potentially harsh penalties, such as

investigation and enforcement of sanctions by the Department, Division, Agency, or applicable

professional board. See Fla. Stat. 790.338(8), 395.1055, 456.072(1)(mm), 456.072(2). These

sanctions include, but are not limited to, revocation of their licenses to practice medicine,



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imposition of administrative fines of up to $10,000 per count or offense, return of fees collected,

issuance of letters of reprimand, and compulsory remedial medical education. See, e.g., Fla. Stat.

456.072(2).

47. The disciplinary proceedings and penalties to which the Physician Gag Lawsubjects health care practitioners for their speech about gun safety are otherwise reserved for

egregious professional misconductsuch as obtaining a license through bribery, making

fraudulent representations related to the practice of medicine, and filing false complaints against

other practitioners. See Fla. Stat. 456.072.

C. Harm to Plaintiffs and Their Patients

48. The Physician Gag Law expressly prohibits health care practitioners from makingcertain inquiries to patients on the subject of firearm safety, expressly prohibits them from

writing certain notes in patients charts regarding their consultations on this topic, and has an

immediate restrictive effect on Plaintiffs exercise of their constitutional right to speak freely to

their patients, in the exercise of their best medical judgment, regarding safe gun ownership.

49. To be sure, Plaintiffs discuss safe gun ownership with patients only because theybelieve such information to be relevant to patients medical care or safety, and Plaintiffs record

information regarding such counseling in patients charts as a matter of course in the belief that

doing so is relevant to patients care. But it is unclear how the Physician Gag Law will be

interpreted or applied by disciplinary bodies, and the law encourages complaints to be brought

against Plaintiffs, even in circumstances in which Plaintiffs believe they would be

constitutionally protected in speaking with their patients about gun safety. The risks posed by

common household hazards to infants, children, and adolescentsincluding risks posed by the

presence of firearmswarrant counseling every young patients parents regarding these risks.



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To that extent, it is therefore always relevant to inquire as to the presence or ownership of a

firearm in the home, and to document such information in patients medical records along with

other information pertinent to patients preventative care. It is far from clear, however, whether

this level of non-particularized relevance will be deemed by the Board of Medicine to be

sufficient to avoid punishment for violating the Physician Gag Law. Indeed, the more specific

safe harbor provision applicable to EMTs gives Plaintiffs a very concrete basis to fear that the

statute will be construed to prohibit inquiring or entering information except in circumstances

related to a medical emergency or imminent threat to health or safety.

50.

The Physician Gag Laws ambiguous prohibitions against harassment and

discrimination based on gun ownership have a similar chilling effect on health care

practitioners speech on the subject of firearm safety. Plaintiffs do not view their counseling as

harassment or discrimination. Nevertheless, one patient may regard as harassment an

inquiry and discussion of gun safety that another patient would welcome. The Physician Gag

Laws prohibitions are so vague, overbroad, and ambiguous, and its penalties so harsh, that

prudent practitioners will be forced to curtail or forgo altogether counseling patients with regard

to firearms.

51. This silencing will occur because the process of public investigation before theDepartment or an applicable professional board, usually reserved for egregious cases of

misconduct, is so harmful to medical professionals reputations that even practitioners who are

eventually vindicated are irreparably harmed; the harm commences along with the mere

investigation. For example, many accrediting organizations and job applications require

physicians to disclose whether they have ever been reported to their state medical boards

regardless whether they were ultimately vindicated. The threat posed by the spectre of being



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reported under this vague, overbroad, and ambiguous statute, which can be done by any

individual patient, is thus sufficient to cause health care practitioners to limit their speech to

patients with respect to firearms or to refuse altogether to counsel patients on this topic.

52. For example, Plaintiff Dr. Bernd Wollschlaeger considers anticipatory guidanceregarding safe firearm practices to be a key part of preventative health consultations, in light of

the significant health risks posed by firearms to his patients. Until passage of the Physician Gag

Law, all of his patients have been asked to complete a preventative-health-related questionnaire

aimed at uncovering specific risk factors, which Dr. Wollschlaeger uses as the basis for taking a

more in-depth, individualized patient history. Heretofore, it has also been his practice to ask

patients about firearm ownership and safe firearm storage if the patients circumstances suggest

that access to guns potentially could result in harm to the patient or others, and he has

documented in childrens charts that their parents have been asked a question on the topic of

firearms as part of their preventative health screening. Nevertheless, the possibility of having to

appear before the Florida Board of Medicine based on a complaint that he violated the Physician

Gag Law has caused and will continue to cause Dr. Wollschlaeger to refrain from discussing

firearms as part of his standard preventative counseling as a precautionary measure, because of

the devastating damage to his professional reputation and business, as well as expense and

personal stress, that would result if such proceedings were brought against him.

53. Plaintiff Dr. Judith Schaechter also has been forced to curtail her speech withpatients on the subject of firearms as a result of the Physician Gag Law. Dr. Schaechter

routinely screens her patients for firearm safety risks during their annual visits for well-child

care. And, as she does with respect to other aspects of her patients care, she records information

regarding firearm ownership in her patients medical records. She views doing so as important,



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because such records communicate to a limited number of doctors within her practice the

discussion that took place with the patient or parent; they document the preventative care that

was given; and they allow her, as a child grows older, to look back and know what topics she

may need to verify, cover again, or expand upon. She is afraid the Physician Gag Law could be

interpreted as allowing doctors to ask about guns only if they believe a danger to the patient is

imminentan interpretation that would preclude this aspect of standard preventative care for her

patients. Nevertheless, because she believes in good faith that such questions are relevant to her

patients health care, she is continuing to ask these routine screening questions following the

laws enactment, despite her immediate fear that a patient, spurred by this law, may as a result

make a report against her to the Board of Medicine. Because of this fear that she may be accused

of violating the Physician Gag Law, she has, however, decided that she will now alter her

practice with respect to patients parents who avoid answering or respond with hostility to

questions regarding firearmsdespite the fact that such counseling on this subject may be

necessary to protect the patients safety. Whereas before this law was passed she would ask such

parents follow-up questions when they avoided answering or responded with hostility to

questions about firearms, she now will forgo such follow-up questions, for fear of being accused

by the patient of violating this law.

54. Plaintiff Dr. Tommy Schechtman, like Dr. Schaechter, will continue in hispractice of routinely asking his patients questions regarding firearm safety and recording related

information in their medical records, because he believes in good faith that such questions and

information are relevant to his patients medical care. Also like Dr. Schaechter, however, as a

result of the Physician Gag Law, Dr. Schechtman will refrain from asking follow-up questions

when patients or their parents seem upset by his initial screening question. Although he



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previously did ask patients and their parents such follow-up questions due to the possibility of

firearms in such households and the need for preventative guidance regarding safely storing

them, Dr. Schechtman now is concerned that such follow-up questions will lead to his being

accused of violating the Physician Gag Law. Even though Dr. Schechtman will censor his own

speech to this extent as a result of the enactment of the Physician Gag Law, he remains

extremely concerned that a patient or parent, prompted by the law, will file a complaint against

him with the Board of Medicine based simply on the fact that he has asked a standard screening

question regarding the presence of firearms in the patients household.

55.

It is no answer to Plaintiffs fear of being accused of violating this law to assert

that they can simply advise their patients on firearm safety without asking their patients any

questions. Health care practitioners cannot provide meaningful counseling on firearm safety

without making inquiries of their patients. Most importantly, such counseling, to be effective,

requires a back-and-forth between patient and practitioner. In an exam room, patient care is by

definition personal; assessment of health, safety, and risk, as well as management of the same, is

customized for each patient. It would be poor practice to provide anything less, and health care

practitioners are not effective when they simply lecture their patients or hand them a pamphlet.

Rather, practitioners converse with their patients, in an attempt to cultivate a relationship of trust,

honesty, and collaboration. This is as true for adolescent diabetes management as it is for child

safety regarding firearm access. Furthermore, for those patients who do not have firearms in

their home, much of what a practitioner would say to a family about possessing firearms would

be irrelevant. Counseling that consisted simply of lecturing such patients on storing their

firearms therefore would waste both practitioners and patients time, and would cause patients

to question their practitioners judgment in discussing at length information irrelevant to their



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lives and health. Even more fundamentally, the First Amendment does not permit the State of

Florida to require practitioners to conform their communications with their patients to the States

preferences.

56. Likewise, the law also effectively disables Plaintiffs from communicating withpatients through their member physicians and through relevant literature created for distribution

to patients.

57. Preventing health care practitioners from counseling their patients on all aspectsof the recommended safety guidance deprives patients of their right to hear such information.

Such brief counseling efforts by practitioners can make a significant positive impact on patients

firearm storage habits. The absence of those efforts undoubtedly will contribute to further

injuries and loss of lives.

58. Dr. Wollschlaeger, for instance, previously routinely asked about firearmownership and safe firearm storage if access to guns could potentially result in harm to the

patient or othersfor example, where patients have children at home; are suffering from

addiction, depression, or suicidal ideations; have an unstable family environment; or are involved

in a domestic violence situation. Thus, before the enactment of the Physician Gag Law, if he

were treating children and learned from their mother that their father owned guns and had an

explosive temper, he would make inquiries of the husband regarding firearms safety as a

preventative health measure. He frequently shared with adult patients and minor patients

parents that he himself is a gun owner and concealed weapon permit-holder, and he has

explained to them the steps he takes to ensure his gun is properly secured. He also has discussed

with them the need to secure their guns from inadvertent use by third parties, avoiding accidental

discharge, and keeping guns out of childrens access. In Dr. Wollschlaegers experience, many



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patients and parents are unaware of how to use child safety mechanisms and lock boxes and the

importance of separately storing guns and ammunition. Such patients and parents have been

appreciative of learning more regarding how they can minimize the risks of physical injury and

death stemming from their ownership of firearms. But Dr. Wollschlaeger no longer will discuss

firearms as part of his standard preventative counseling, for fear of being accused of violating the

Physician Gag Lawthus increasing the risk of firearm injuries for his patients and others in

their households.

59. Plaintiff Dr. Schaechters experience has been that asking about firearms in thehome prompts discussions with patients and parents. She has found that, following these

counseling sessions, many parents take her advice and implement measures that can prevent

accidents, because they want to protect their children. Sadly, however, she also has lost many

patients to gunshot wounds, including in incidents where guns found in a childs home or

belonging to a family member inflicted the wounds. Dr. Schaechter views these injuries as

preventable. She is concerned that undermining anticipatory safety guidance regarding firearms

may lead to more preventable deaths and grievous injuries to patients.

60. Plaintiff Dr. Schechtman also has found in his experience that his patients levelof knowledge regarding firearm safety varies. He believes that his practice of providing

preventative guidance on firearm safety has been informative, has changed behavior, or even has

prevented serious injury or death for many of his patients. He occasionally has had experience in

the past with patients becoming upset by follow-up questions when patients did not respond to a

question regarding firearm safety on a written questionnaire that he gives patients, which asks

about firearms among many other risk factors. Recently, a 16-year-old patient became upset

when a nurse practitioner in his practice asked the patient a follow-up question in response to the



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patients failure to respond to the question about firearms. Because of the enactment of the

Physician Gag Law, Dr. Schechtman now will refrain from asking such follow-up questions in

similar circumstances, out of the fear that he will be accused of violating the law.

61. Members of FAAP, FAFP, and FACP, including Dr. Wollschlaeger (FAFP), Dr.Schaechter (FAAP), Dr. Schechtman (FAAP), Dr. Lisa A. Cosgrove (FAAP), Dr. Stuart

Himmelstein (FACP), and Dr. Dennis Mayeaux (FAFP), also will, as a result of the Physician

Gag Law, curtail, modify, or cease altogether speech in which they otherwise would engage

with patients as part of their medical care.

62.

In light of the foregoing, Plaintiffs FAAP, FAFP, and FACP submitted a letter to

Defendant Scott on May 27, 2011, formally requesting that he veto the Physician Gag legislation

because it is unconstitutional. Notwithstanding that request, Defendant Scott signed the

Physician Gag Law into law on June 2, 2011.

CLAIM FOR RELIEF

COUNT I: VIOLATION OF 42 U.S.C. 1983

63. Plaintiffs reallege and incorporate by reference the preceding allegations inparagraphs 1 through 62 as though fully set forth herein.

64. The First Amendment to the U.S. Constitution provides that Congress shall makeno law . . . abridging the freedom of speech, or of the press; or the right of the people peaceably

to assemble, and to petition the Government for a redress of grievances. The First Amendment

is applicable to the States under the Fourteenth Amendment to the U.S. Constitution.

65. The Fourteenth Amendment provides that [n]o state shall . . . deprive any personof life, liberty, or property, without due process of law.

66. The Physician Gag Law violates the First and Fourteenth Amendments:



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(a) By abridging the freedom of Plaintiffs Dr. Bernd Wollschlaeger, Dr. Judith

Schaechter, Dr. Tommy Schechtman, FAAP, FAFP, and FACP,and of their members, to

communicate with and to counsel their patients, using their best medical judgment in

practicing preventative medicine, regarding minimizing the risks associated with

firearms;

(b) By failing to give Plaintiffs Dr. Bernd Wollschlaeger, Dr. Judith Schaechter, and

Dr. Tommy Schechtman and the members of Plaintiffs FAAP, FAFP, and FACP

adequate notice of the conduct prohibited under the Physician Gag Law; and

(c) By abridging the freedom of Plaintiffs and their members patients to receive

such information as part of their preventative care.

PRAYER FOR RELIEF

WHEREFORE, Plaintiffs respectfully request that this Court enter judgment in their

favor and that the Court:

(A) Declare that the Physician Gag Law violates the First and Fourteenth Amendments

to the Constitution of the United States;

(B) Preliminarily and permanently enjoin Defendants from enforcing the Physician Gag

Law;

(C) Award Plaintiffs the costs incurred in pursuing this action, including attorneys fees

pursuant to 42 U.S.C. 1988, and reasonable expenses; and

(D) Grant such other and further relief as the Court deems proper.



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Dated: June 6, 2011 Respectfully submitted,

_/s/ Edward M. Mullins _________________Edward M. Mullins (Fla. Bar No. 863920)

[email protected] M. Lucas (Fla. Bar No. 853011)[email protected] DAVIS MULLINS

& GROSSMAN, P.A.701 Brickell Avenue, 16

thFloor

Miami, Florida 33131-2847Telephone: (305) 372-8282Facsimile: (305) 372-8202

-and-

Bruce S. Manheim, Jr.*[email protected] H. Hallward-Driemeier*[email protected] M. Ripa*[email protected] M. Lewis*[email protected] & GRAY LLP700 12th Street NW, Suite 900

Washington D.C. 2005Telephone: (202) 508-4600Facsimile: (202) 383-8332

-and-

Jonathan E. Lowy *[email protected] R. Vice*[email protected] CENTER TO PREVENT

GUN VIOLENCELegal Action Project1225 Eye Street, NWSuite 1100Washington, DC 20005Telephone: (202) 289-7319Facsimile: (202) 898-0059



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-and-

Dennis G. Kainen (Fla. Bar No. 0339393)

WEISBERG & KAINEN P.L.1401 Brickell AvenueSuite 800Miami, Florida 33131-3504Telephone: (305) 374-5544Facsimile: (305) [email protected]

*Pro hac vice applications pending

Counsel for Plaintiffs


Documents

Lawsuit defending doctors' right to ask patients about firearms